CASE REPORT : Familial Mediterranean Fever With Complete Symptomatic Remission During Pregnancy

( Kwang Taek Kim ),( Hyun Joo Jang ),( Jae Eun Lee ),( Mi Kang Kim ),( Jun Jae Yoo ),( Gye Yeon Lee ),( Sea Hyub Kae ),( Jin Lee ) 대한장연구학회 2015 Intestinal Research Vol.13 No.3

Familial Mediterranean fever (FMF) is an inherited autosomal recessive disorder, ethnically restricted and commonly found among populations surrounding the Mediterranean Sea. FMF is the most prevalent autoinflammatory disease; is characterized by recurrent, self-limited episodes of fever with serositis; and is caused by Mediterranean fever gene (MEFV) mutations on chromosome 16. We describe a case of adult-onset FMF with complete symptomatic remission during pregnancy, without the use of colchicine. A 25-year-old woman had presented with periodic fever, abdominal pain, and vomiting since she was 21. Her abdominal computed tomography scan showed intestinal nonrotation. She underwent exploratory laparotomy and appendectomy for her symptoms 1 year prior. She had a symptom-free pregnancy period, but abdominal pain and fever recurred after delivery. Mutation analysis of the MEFV gene revealed two point mutations (p.Leu110Pro and p.Glu148Gln). We report an adult female patient with FMF in Korea with complete symptomatic remission during pregnancy. (Intest Res 2015;13:287-290)

간세포암 환자에서 DNase , RNase 및 Rnase inhibitor 측정의 의의

계세협(Sea Hyub Kae),정유선(Yoo Sun Chung),장현주(Heon Ju Jang),정선화(Sun Wha Jung),김용태(Yong Tae Kim),강승식(Seung Sik Kang),이진(Jin Lee),곽상택(Sang Taek Kwak),주상언(Sang Aun Joo),유재영(Jae Young Yoo) 대한내과학회 1998 대한내과학회지 Vol.54 No.5

N/A Objective Activities of nucleases (acid DNase and neutral RNase) and RNase inhibitor 1mown to be involved in carcinogenesis and suppression of cancer were determined in cancer tissue, serum and ascitic fluid of patients with hepatocellular carcinoma and were compared with those of the controls. Also studied were nucleases and RNase inhibitor isolated from hepatocellular carcinoma tissue and ascitic fluid of the cancer patients to evaluate the properties and interactions between them. Method: Activities of nucleases and RNase inhibitor were measured in cancer tissue, serum and ascitic fluid of patients with hepatocellular carcinoma by ultraviolet spectrophotometry. Nucleases and RNase inhibitor were isolated from hepatocellular carcinoma tissue and ascitic fluid of the cancer patients by DEAE-cellulose column chromatography. As controls, normal tissue of the cancer patients, serum of healthy persons and ascitic fluid of cirrhotic patients were used. Result: Activities of DNase, RNase and RNase inhibitor were significantly increased in hepatocellular carcinoma tissue. DNase activity was not detected, RNase activity was increased and RNase inhibitor activity was unchanged in both serum and ascitic fluid of the hepatocellular carcinoma patients. DNase was isolated as a single enzyme and RNase as seven isozymes from the hepatocellular carcinoma tissue. The DNase isolated preferentially cleaved ds DNA over ss DNA and was endonuclease in nature (majority of hydrolytic products of DNA by the DNase were oligodeoxyribonucleotides). Of seven RNase isozymes isolated from the hepatocellular carcinoma tissue, isozyme I exhibited nonsecretory nature of RNase and other six isozymes secretory nature of the enzyme. Activity of RNase isozyme V was greatly increased and the activity of inhibitor complexed with the isozyme V was also increased. RNase in ascitic fluid of the cancer patient was separated into four isozymes, of which isozyme I exhibited mixed form of secretory and nonseretory nature and greatly increased in its activity. RNase isozyme V isolated in the hepatocellular carcinoma tissue was not detected in the ascitic fluid, Conclusion: The use of the nucleases and the inhibitor in the cancer tissue as biochemical markers for the hepatocellular carcinoma was suggested. RNase was released into the body fluid from the cancer tissue and could be used as a diagnostic marker for the hepatocellular carcinoma. An important rale of the DNase in carcinogenesis of the liver was suggested. RNase isozyme V was limited in the cancer tissue and RNase isozyme I and V and inhibitors associated with these isozymes might be involved in carcinogenesis processes, suppression of cancer and maintenance of tocellular carcinoma through their interactions.

Outcomes of the Conventional versus Pocket-Creation Method for Endoscopic Submucosal Dissection of Gastric Body Tumors Using a Dual Knife: A Retrospective Study

Lee Sang Pyo,Jang Hyun Joo,Kae Sea Hyub,Lee Jae Gon 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.4

Background/Aims: Various endoscopic submucosal dissection (ESD) methods for gastric tumors have been tried. However, no studies have yet compared results according to the ESD method for gastric body tumors using a dual knife. The objective of this study was to compare outcomes of two ESD methods for gastric body tumors: the pocket-creation method and conventional method. Methods: Patients who underwent ESD for a gastric body tumor were retrospectively reviewed. Patients were divided into two groups according to the ESD method: the conventional method (group I) and pocket-creation method (group II). Characteristics of patients and tumors, hospitalization period, incidence of complications, resection margin status, incidence of surgical operation, procedure time, and laboratory findings were investigated. Results: Of the total of 100 patients, 52 belonged to group I and 48 to group II. All tumors were successfully resected en bloc. Resection margin involvement was found in six (11.5%) of group I and six (12.5%) of group II. Complications were observed in seven (13.5%; major complication five, minor two) of group I and eight (16.7%; major two, minor six) of group II. There were no significant differences in ESD outcomes such as hospitalization period, incidence of complications, resection margin status, incidence of surgical operation, procedure time, or inflammatory response after ESD between the two groups. Conclusions: Both methods are suitable for treating gastric body tumors with adequate treatment success rates and comparable complication rates.

Diagnostic Accuracy of Fecal Calprotectin for the Detection of Small Bowel Crohn’s Disease through Capsule Endoscopy: An Updated Meta-Analysis and Systematic Review

( Eun Suk Jung ),( Sang Pyo Lee ),( Sea Hyub Kae ),( Jung Han Kim ),( Hyeong Su Kim ),( Hyun Joo Jang ) 대한소화기학회 2021 Gut and Liver Vol.15 No.5

Background/Aims: The diagnosis of small bowel Crohn’s disease with negative ileocolonoscopic findings has been challenging. Fecal calprotectin (FC) has been used to detect colonic inflammation, but its efficacy for detecting small bowel inflammation is less established. We performed an updated meta-analysis to evaluate the diagnostic accuracy of FC to detect active small bowel inflammation observed during capsule endoscopy. Methods: We conducted a systematic literature search for studies that evaluated the correlation between small bowel inflammation and FC in patients with suspected/established Crohn’s disease. We calculated the pooled sensitivity, specificity, and diagnostic odds ratios (DORs) and constructed hierarchical summary receiver operating characteristic curves for FC cutoffs of 50, 100, and 200 μg/g. Results: Fourteen studies were eligible for the final analysis. The DORs of all FC cutoffs were significant. The highest DOR was observed at 100 μg/g (sensitivity, 0.73; specificity, 0.73; and DOR, 7.89) and was suggested as the optimal diagnostic cutoff. If we analyzed only studies that included patients with suspected Crohn’s disease, the DOR was 8.96. If we analyzed only studies that included patients with a Lewis score ≥135 as a diagnostic criterion for active disease, the DOR was 10.90. Conclusions: FC has significant diagnostic accuracy for detecting small bowel inflammation, and an FC cutoff of 100 μg/g can be used as a tool to screen for small bowel Crohn’s disease. (Gut Liver 2021;15:732-741)

선암으로의 이행이 관찰된 가족성 대장 폴립증 1 예

이성록,이철우,오인택,주상언,계세협,진학구,이호순 대한내과학회 1989 대한내과학회지 Vol.37 No.1

Familial polyposis coli is a rare hereditary disease characterized by the appearance of numerous polyps in the large intestine with a high potential for malignant transformation. The disease has considerable value in the elucidation of many problems of gastrointestinal disease, especially in the fields of genetics, histopathology and cancer control, as one of the sources for evidence supporing the adenoma-carcinoma sequence. In Korea, several cases were reported, but there were none which showed malignant transformation after a considerable period. We experienced a case of familial polyposis coli which transformed to adenocarcinoma after aperiod of a year and two months, and we report this with a brief review of the literature.

간세포암종 지표로서의 NUCLEASE에 대한 연구

고재경,한중수,김영미,김영식,계세협 한양대학교 의과대학 1996 한양의대 학술지 Vol.16 No.2

Activities of nucleases (acid DNase and neutral RNase) known to be involved in carcinogenesis and suppressionof cancer were determined in cancer tissue, serum and ascitic fluid of patients withhepatocellular carcinoma and were compared with those ofthe controls. Also studied were nucleases and nuclease-inhibitors isolated from hepatocellular carcinoma tissue and ascitic fluid of the cancer patients to evaluate the properties and interactions between them. Activites of DNase, RNase and RNase inhibitor were significantly increased, suggesting the use of the nucleases and the inhibitor as biochemical markers for the hepatocellular carcinoma. DNase activity was not detected, RNase activity was increased and RNase inhibitor activity was unchanged in both serum and ascitic fluid of the hepatocellular carcinoma patients. The results indicated that RNase was released into the body fluid from the cancer tissue and that the RNase could be used as a diagnostic marker for the hepatocellular carcinoma. DEAE-cellulose column chromatographical analyses revealed that DNase was isolated as a single enzyme and RNase as seven isozymes from the hepatocellular carcinoma tissue. The DNase isolated was perferentially cleaved ds DNA over ss DNA and was endonuclease in nature (majority of hydrolytic products of DNA by the DNase were oligodeoxyribonucleotides), suggesting an important role of the DNase in carcinogenesis of the liver. Of seven RNase isozymes isolated from the hepatocellular carcinoma tissue, isozyme I exhibited nonsecretory nature of RNase and other six isozymes secretory nature of the enzyme. Activity of RNase isozyme V was greatly increased and the activity of inhibitory complexed with the isozyme V was also increased in the cancer tissue. RNase in ascitic fluid of the cancer patient was separated into four isozymes, of which isozyme I exhibited mixed form of secretory and nonsecretory nature and greatly increased in its activity. RNase isozyme V isolated in the hepatocellualr carcinoma tissue was not detected in the ascitic fluid. The results indicated that RNase isozyme V was limited in the cancer tissue and that RNase isozyme I and V and inhibitors associated with these isozymes might be involved in carcinogenesis processes, supression of cancer and maintenance of hepatocellular carcinoma through their interactions.

알코올성 간질환 환자에 있어서 혈청 Type IV Collagen 측정의 유용성

이진,강승식,박철희,주상언,계세협,장웅기,임창재,곽상택,임해성,정유선 대한소화기학회 1999 대한소화기학회지 Vol.33 No.2

Background/Aims: Serun type IV collagen (IV-C) is known to be related to hepatic fibrosis. This study was performed to evaluate the clinical usefulness of IV-C measurement as an index of hepatic fibrosis in patients with chronic liver diseases, especially chronic alcoholic liver diseases. Methods: The IV-C was measured in 16 cases of chronic persistent hepatitis (CPH) B, 16 cases of chronic active hepatitis (CAH) B, 18 cases of hepatitis B associated liver cirrhosis, 12 cases of alcoholic hepatitis, 18 cases of alcoholic cirrhosis, and 16 normal controls. The concentration of IV-C was determined by one-step sandwich enzyme immunoassay. Results: The concentration of IV-C in vira cirrhosis group (356.4 ±96.1 ng/mL) was significantly (p$lt;0.05) higher than that in the CPH group (121.1 ±47.4 ng/mL), the CAH group (141.5 ±75.5 ng/mL) and normal controls (90.1 ±13.7 ng/mL) The concentration of IV-C in alcoholic cirrhosis group (956.6 ±334.5 ng/mL) was significantly (p$lt;0.05) higher than that in alcoholic hepatitiup (147.5 ±55.5 ng/mL) and normal controls (90.1 ±13.7 ng/mL). The concentration of IV-C in alcoholic liver disease group (632.9 ±478.8 ng/mL) was significantly (p$lt;0.05) higher than that in chronic viral liver disease group (212.4 ±132.8 ng/mL). The concentration of IV-C in alcoholic cirrhosis group (956.6 ±334.5 ng/mL) was significantly (p$lt;0.05) higher than that in viral cirrhosis group (356.4 ±96.1 ng/mL). Conclusions: The IV-C level was no a sensitive index for degree of fibrosis progression in chronic viral liver disease. However, we suggest that it can be a crude marker in monitoring cirrhotic change in chronic hepatitis, especially in alcoholic hepatitis. (Kor J Gastroenterol 1999;33:222 - 231)

간경변증 환자의 수분 전해질 평형 및 신기능에 있어서 혈청 Endothelin - 1 의 역할

이진(Jin Lee),박철수(Cheol Soo Park),박철희(Cheol Hee Park),계세협(Sea Hyub Kae),곽상택(Sang Taek Kwak),주상언(Sang Aun Joo),김호중(Ho Jung Kim),기춘석(Choon Suhk Kee) 대한내과학회 1997 대한내과학회지 Vol.52 No.4

N/A Objectives: It has been recently known that endotheUn-1 is a potent vasoconstrictor. The purpose of the present study was to clarify the possible correlation of endothelin-1 with other vasoactive neurohormonal activities and its effects on fluid- electrolyte balance and renal function in patients with liver cirrhosis. Mcthods: In 35 patients of liver cirrhosis with (n=19) and without (n=16) ascites and in 12 normal controls, plasma and urine levels of endothelin-1 were measured by specific radioimmunoassay, and serum sodium, serum albumin and other blood chemistries, renal functions with creatinine clearance, urinary sodium excretion, plasma renin activity, plasma aldosterone and plasma norepinephrine were measured at the same time. Results: The plasma endothelin-1 level was significantly higher in ascitic group than nonascitic group (mean±SD; 16.4±10.6 VS. 7.5±4.1pg/mL, p=0.0000), and there was no significant difference in plasma endothelin-1 level between nonascitic group and normal controls(4.8±1.9pg/mL). The urine endothelin-1 level also was significantly higher in ascitic group than non-ascitic group (140.3±74.3 VS. 58.5±37.4 pg/mL, p=0.0000), there was no significant difference in urine endothelin-1 level between nonascitic group and normal controls (19.5±112pg/mL). In patients with cirrhosis, the plasma endothelin-1 concentration showed significant negative correlation with creatinine clearance (r=-0.55), serum albumin (r=-0.56%) and serum sodium concentrtion (r=-0.62), and significant positive correlation with plasma renin activity (r=0.63), plasma aldosterone (r=0.68) and norepinephrine (r=0.70). The factors that influence on plasma concentration of endothelin-1 were plasma norepinephrine (p=0.0000), serum sodium (p=0.0169), plasma aldosterone (p=0.0176), serum albumin (p=0.0213) and plasma renin activity (p=0.0329) in statistically significant order. Conclusion: The elevated plasma endothelin-1 level along with the increased activity of other neurohormonal substances including plasma renin, aldosterone and norepinephrine induces sodium and water retention in decompensated liver cirrhosis. Thus, the plasma endothelin-1 level seems to have an important role in the development of functional renal impairment in decompensated liver cirrhosis by inducing renal vasoconstriction.

Menetrier`s Disease 1예 보고

권영배,김진한,오인택,주상언,계세협,전노원 대한소화기내시경학회 1989 Clinical Endoscopy Vol.9 No.1

Menetrier's disease is a rare disease characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss and edema due to gastric protein loss. The 48-year-old male patient was admitted to the Hangang Sacred Heart Hospital with cheif complaints of indigestion and epigastric pain. The diagnosis of Menetriers disease is established by radiologic, endoscopic, and pathologic examination. He was treated with soft diet, antacid, H2- receptor antagonist, and IV albumin. We report a case of Menetriers disease with brief review of literatures.

위 선암종과 유두상 갑상선암종이 병발한 동시성 중복암 1예

이진,김정한,조진원,강승식,계세협,정현주,김창억,주상억 대한소화기학회 2000 대한소화기학회지 Vol.35 No.3

Multiple primary cancer is that more than two cancers with different origin exist independently. Although there are many case reports and reviews about stomach cancer associated double primary cancer in Korea, the case of synchronous double cancer of stomach and thyroid was not reported yet. We report a case of synchronous double primary cancer of gastric adenocarcinoma and thyroid papillary carcinoma in 64-year-old man who complained of epigasric pain. It was confirmed by gastroscopic biopsy and surgical specimens.